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January 2016 Sun Mon Tues Wed Thu Fri Sat1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24/31 25 26 27 28 29 30You can send this in with your pay stubs to SSA. Keep a copy for your own
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